Anatomy for Blepharoplasty and Brow-lift

ABSTRACT

The eyelids and eyebrows provide communicative, emotional, and protective functions through a complex interplay of muscles, tendons, and other local soft tissues. A surgical intervention involving these regions are renowned for their deceptive simplicity and notable complications. With these challenges in mind, this article provides the reader with a detailed and systematic review of the eyelid and brow anatomy.

KEYWORDS

Blepharoplasty - brow-lift - anatomy - eyelid

REFERENCES

• 1 Most S P, Mobley S R, Larrabee Jr W F. Anatomy of the eyelids.  Facial Plast Surg Clin North Am. 2005;  13 487-492, v
• 2 Yanoff M, Duker A. Ophthalmology, 3rd ed. St. Louis, MO; Mosby Elsevier 2008: 1379-1382
• 3 Gioia V M, Linberg J V, McCormick S A. The anatomy of the lateral canthal tendon.  Arch Ophthalmol. 1987;  105 529-532
• 4 Putterman A M, Urist M J. Surgical anatomy of the orbital septum.  Ann Ophthalmol. 1974;  6 290-294
• 5 Mendelson B C. Fat preservation technique of lower-lid blepharoplasty.  Aesthet Surg J. 2001;  21 450-459
• 6 May Jr J W, Fearon J, Zingarelli P. Retro-orbicularis oculus fat (ROOF) resection in aesthetic blepharoplasty: a 6-year study in 63 patients.  Plast Reconstr Surg. 1990;  86 682-689
• 7 Persichetti P, Di Lella F, Delfino S, Scuderi N. Adipose compartments of the upper eyelid: anatomy applied to blepharoplasty.  Plast Reconstr Surg. 2004;  113 373-378; discussion 379–380
• 8 Lemke B N, Stasior O G, Rosenberg P N. The surgical relations of the levator palpebrae superioris muscle.  Ophthal Plast Reconstr Surg. 1988;  4 25-30
• 9 Anderson R L, Beard C. The levator aponeurosis. Attachments and their clinical significance.  Arch Ophthalmol. 1977;  95 1437-1441
• 10 Kakizaki H, Zako M, Nakano T, Asamoto K, Miyaishi O, Iwaki M. The levator aponeurosis consists of two layers that include smooth muscle.  Ophthal Plast Reconstr Surg. 2005;  21 379-382
• 11 Jeong S, Lemke B N, Dortzbach R K, Park Y G, Kang H K. The Asian upper eyelid: an anatomical study with comparison to the Caucasian eyelid.  Arch Ophthalmol. 1999;  117 907-912
• 12 Kuwabara T, Cogan D G, Johnson C C. Structure of the muscles of the upper eyelid.  Arch Ophthalmol. 1975;  93 1189-1197
• 13 Jones L T. The lacrimal secretory system and its treatment. Indian J Ophthalmol 1966 14: 191-196 Available at: http://www.ijo.in/text.asp?1966/14/5/191/38653 Accessed May 11, 2010
• 14 Kawai K, Imanishi N, Nakajima H, Aiso S, Kakibuchi M, Hosokawa K. Arterial anatomical features of the upper palpebra.  Plast Reconstr Surg. 2004;  113 479-484
• 15 Ducasse A, Segal A, el Ladki S, Flament J B. [Arterial vascularization and innervation of the lacrimal gland. Apropos of 100 dissections].  Ophtalmologie. 1990;  4 129-133
• 16 Cook Jr B E, Lucarelli M J, Lemke B N et al.. Eyelid lymphatics I: histochemical comparisons between the monkey and human.  Ophthal Plast Reconstr Surg. 2002;  18 18-23
• 17 Cook Jr B E, Lucarelli M J, Lemke B N et al.. Eyelid lymphatics II: a search for drainage patterns in the monkey and correlations with human lymphatics.  Ophthal Plast Reconstr Surg. 2002;  18 99-106
• 18 Westmore M G. Facial cosmetics in conjunction with surgery. Course presented at: Aesthetic Plastic Surgery Society. May 7, 1974 Vancouver, Canada;
• 19 Cook T A, Brownrigg P J, Wang T D, Quatela V C. The versatile midforehead browlift.  Arch Otolaryngol Head Neck Surg. 1989;  115 163-168
• 20 Knize D M. An anatomically based study of the mechanism of eyebrow ptosis.  Plast Reconstr Surg. 1996;  97 1321-1333
• 21 Whitnall S E. Anatomy of the Human Orbit and Accessory Organs of Vision, 2nd ed. London, UK; Oxford University Press 1932: 109-115
• 22 Lemke B N, Stasior O G. The anatomy of eyebrow ptosis.  Arch Ophthalmol. 1982;  100 981-986
• 23 Quatela V C, Davis K G. Rejuvenation of the brow and mid-face.  Oper Tech Otolaryngol--Head Neck Surg. 1999;  10 160-168
• 24 Burroughs J R, Bearden W H, Anderson R L, McCann J D. Internal brow elevation at blepharoplasty.  Arch Facial Plast Surg. 2006;  8 36-41
• 25 Bernstein L, Nelson R H. Surgical anatomy of the extraparotid distribution of the facial nerve.  Arch Otolaryngol. 1984;  110 177-183
• 26 Zide B M. Surgical Anatomy Around the Orbit: The System of Zones. Philadelphia, PA; Lippincott Williams & Wilkins 2006: 19-42
• 27 Sabini P, Wayne I, Quatela V C. Anatomical guides to precisely localize the frontal branch of the facial nerve.  Arch Facial Plast Surg. 2003;  5 150-152